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LAKESIDE MEDICAL ASSOCIATES A MEDICAL GROUP INC. NPI 1962667857


NPI Information

NPI: 1962667857
Provider Name: LAKESIDE MEDICAL ASSOCIATES, A MEDICAL GROUP, INC.

Doing Business As: LAKESIDE COMMUNITY HEALTHCARE MEDICAL GROUP

Classification: Obstetrics & Gynecology - 207V00000X
Entity Type: Organization
Address:
191 S BUENA VISTA ST
SUITE 440
BURBANK, CA
ZIP 91505
Phone: (818) 848-3763
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LAKESIDE MEDICAL ASSOCIATES, A MEDICAL GROUP, INC. is an obstetrics gynecology in Burbank, CA. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. LAKESIDE MEDICAL ASSOCIATES, A MEDICAL GROUP, INC. NPI is 1962667857. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Lakeside Community Healthcare Medical Group.

The provider's business location address is:

191 S BUENA VISTA ST
SUITE 440
BURBANK, CA
ZIP 91505-504
Phone: (818) 848-3763
Fax: (818) 848-3785

The provider's authorized official is Kerry E. Weiner .
The authorized official title is President and has the following contact phone number (818) 637-2000.

The enumeration date for this NPI number is 7/21/2008 and was last updated on 5/11/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207V00000XObstetrics & GynecologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11962667857MEDICAIDCALIFORNIA
2W12279MEDICARE PIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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